Improved early and late continence following robot-assisted radical prostatectomy with concurrent bladder neck fascial sling (RoboSling)

Objective: To describe a novel RoboSling technique performed at the time of robot-assisted radical prostatectomy (RARP) and its utility for enhancing urinary function recovery postoperatively. Materials and Methods: The surgical technique involves harvesting a vascularised, fascial flap from the peritoneum on the posterior aspect of the bladder. Following completion of prostatectomy, the autologous flap is tunnelled underneath the bladder and incorporated into the rectourethralis and vertical longitudinal detrusor fibres at the posterior bladder neck with a modified Rocco suture. After urethra-vesical anastomosis is completed, the corners of the flap are hitched up to Cooper's ligament bilaterally with V-Loc sutures, tensioned and secured creating a bladder neck sling. A prospective, longitudinal cohort study was performed of 193 consecutive patients undergoing RARP between December 2016 and September 2019. The first 163 patients underwent standard RARP, and the last 30 patients had the RoboSling technique performed concurrently. Continence outcomes were the primary outcomes assessed using pad number and Expanded Prostate Cancer Composite (EPIC)-urinary domain questionnaire. Operative time (OT), estimated blood loss (EBL), complications and oncological outcomes were secondary outcomes. Results: The two groups were comparable for demographics and clinicopathological variables. At 3 months, zero pad usage (p = 0.005) and continence rates, defined as EPIC score ≥ 85 (p = 0.007), were both higher in the RoboSling group. EBL, complication rate and positive surgical margin rate did not differ between the two groups. Superior zero pad usage was observed at 1 year in the RoboSling group (p = 0.029). The RoboSling technique added on average 16 min to OT. Conclusions: The RoboSling procedure at the time of RARP was associated with earlier return to continence without negatively impacting other postoperative outcomes. This improvement in continence outcomes was maintained long term.</p

Conversion Rate of Abstracts Presented at the Société Internationale d’Urologie into Peer-Reviewed Journal Publications

ObjectivesThe objective of this study was to determine the publication rate of abstracts presented at the Société Internationale d’Urologie (SIU) Congress and to analyse the characteristics associated with conversion to publication. MethodsAll abstracts from the 36th Congress of the Société Internationale d’Urologie were identified from the published 2016 abstract book. A PubMed search was performed using key words and author names to identify published journal articles corresponding with the presented abstracts. ResultsThe conversion rate of presented abstracts to publication by April 2022 was 30.73% (224 of 729). Many abstracts were published prior to presentation (35.27%, 79 of 224). The average time to publication of abstracts published post presentation was 16.88 months. The majority of abstracts were presented in urology-specific journals (66.96%, 150 of 224). Publishing journals had an average impact factor of 3.068 with Urology (18 of 224) and Worl d Journal of Urology (8 of 224) being the most common journals. Moderated ePosters had the highest conversion rate to publication (39.59%), whilst Unmoderated Videos had the lowest (11.32%). The abstract book assigned presentation topic groups to the moderated ePoster category; the most published abstract topic was sexual function (68.75%, 11 of 16). ConclusionsThe conversion rate of abstracts presented at the SIU to publications in peer-reviewed journals has shown improvement since previous reports; however, it remains lower than the rates associated with other major urological conferences. Almost 70% of presented abstracts do not convert to publication and this should be considered when incorporating abstract findings into clinical practic

A novel approach using electroacupuncture for erectile dysfunction after radical prostatectomy : a case report

Introduction: Research shows that electrical stimulation to damaged peripheral nerves has promising effects on nerve regeneration and recovery of function. Description: A 71 yr. old male, who was 12 months post left intrafacial and right incremental nerve sparing robotic radical prostatectomy received 6 sessions of sacral electroacupuncture/acupuncture at weekly intervals, commencing 12 months post operatively. Methods: CARE guidelines informed the case study report. Positive changes in erectile function after electroacupuncture was recorded using validated scores (IIEF-5 and EHS). Qualitative information was collected via a feedback box. Discussion: Given that current treatments for post radical prostatectomy erectile dysfunction are invasive and largely unsuccessful, further investigation into electroacupuncture for this population should be pursued

Improved early and late continence following robot-assisted radical prostatectomy with concurrent bladder neck fascial sling (RoboSling)

Objective: To describe a novel RoboSling technique performed at the time of robot-assisted radical prostatectomy (RARP) and its utility for enhancing urinary function recovery postoperatively. Materials and Methods: The surgical technique involves harvesting a vascularised, fascial flap from the peritoneum on the posterior aspect of the bladder. Following completion of prostatectomy, the autologous flap is tunnelled underneath the bladder and incorporated into the rectourethralis and vertical longitudinal detrusor fibres at the posterior bladder neck with a modified Rocco suture. After urethra-vesical anastomosis is completed, the corners of the flap are hitched up to Cooper's ligament bilaterally with V-Loc sutures, tensioned and secured creating a bladder neck sling. A prospective, longitudinal cohort study was performed of 193 consecutive patients undergoing RARP between December 2016 and September 2019. The first 163 patients underwent standard RARP, and the last 30 patients had the RoboSling technique performed concurrently. Continence outcomes were the primary outcomes assessed using pad number and Expanded Prostate Cancer Composite (EPIC)-urinary domain questionnaire. Operative time (OT), estimated blood loss (EBL), complications and oncological outcomes were secondary outcomes. Results: The two groups were comparable for demographics and clinicopathological variables. At 3 months, zero pad usage (p = 0.005) and continence rates, defined as EPIC score ≥ 85 (p = 0.007), were both higher in the RoboSling group. EBL, complication rate and positive surgical margin rate did not differ between the two groups. Superior zero pad usage was observed at 1 year in the RoboSling group (p = 0.029). The RoboSling technique added on average 16 min to OT. Conclusions: The RoboSling procedure at the time of RARP was associated with earlier return to continence without negatively impacting other postoperative outcomes. This improvement in continence outcomes was maintained long term.</p